Meds for test 1 Flashcards
Common drug therapy for RA:
NSAIDS (short-term use)
DMARDS
Corticosteroids
BRM’s
Other immunosuppressive agents
Common drug therapy for OA:
NSAIDS (short-term use)
Acetaminophen
other analgesics
celecoxib (Celebrex) (Cox 2 inhibitor) is usually first choice unless patient has
Hypertension
kidney disease
Cardiovascular disease
Biological response modifier used for RA:
Etanercept (Enbrel - subQ)
Infliximab (Remicade- single IV infusion over several hrs)
Adalimumab (Humira- subQ)
Anakinra (Kineret- subQ)
Abatacept (Orencia- IV)
Rituximab (Rituxan- IV)
Golimumab (Simponi- subQ)
Tocilizumab (Actemra- IV)
First-line disease modifying antirheumatic drugs (3)
Methotrexate (Rheumatrex)
Leflunomide (Arava)
Hydroxychloroquine (Plaquenil) -antimalarial, watch for retinal damage
Prednisone (deltasone) is a
glucocorticosteroid, fast acting anti-inflammatory and immunosuppressive)
Bisphosphonates (abr)
common drug used for osteoporosis
alendronate (Fosamax)
Ibandronate (Boniva)
risedronate (Actonel, Atelvia)
commonly used for prevention and treatment of osteoporosis
Drug therapy for osteoporosis
Calcium supplements
Bisphosphonates
Estrogen agonist/antagonist (Raloxifene- Evista)
Drug therapy for Paget’s disease
NSAID (ibuprofen)
Oral BP’s
Calcitonin
Normal ESR labs:
male: up to 15 mm/hr
Female: up to 20 mm/hr
Normal HsCRP labs:
< 1.0 mg/dl or <10.0 mg/L
Normal serum complement C3 & C4 labs
Total: 30-75 units/mL
C3: 75-175 mg/dL;
C4: 22-45 mg/dL
Normal SPEP labs:
6.4-8.3 g/dL
Drugs that can cause Osteoporosis:
Corticosteroids
Anti-epileptic drugs (phenytoin)
Barbiturates (phenobarbital)
Ethanol (alcohol)
Drugs that induce hypogonadism
High levels of thyroid hormone
Cytotoxic agents
Loop diuretics
Immunosuppressants
Osteoporosis clinical manifestations:
dowager’s hump or kyphosis of dorsal spine
decreased height
back pain
fractures
no definitive lab tests
Osteomalacia clinical manifestations:
early stage- non specific
muscle weakness, bone pain
muscle cramping- hypocalcemia
Musculoskeletal manifestations of Paget’s disease
bone and joint pain that is aching, poorly described, and aggravated by walking
low back pain and sciatic nerve pain
bowing of long bones
loss of normal spinal curvature
enlarged, thick skull
pathologic fractures
Skin manifestations of Paget’s disease:
flushed, warm skin
Other manifestations of Paget’s disease:
apathy, lethargy, fatigue
hyperparathyroidism
gout
urinary or renal stones
heart failure from fluid overload
Acute osteomyelitis key features
fever
swelling around area
erythema of affected area
tenderness of area
bone pain that is constant, localized and pulsating, intensifies with movement
Chronic osteomyelitis features
foot ulcers (MOST COMMON)
Sinus tract formation
localized pain
drainage from affected area
Osteomyelitis diagnostics
CBC
ESR
Blood culture/wound culture
x-rays/CT scan
MRI
Biopsy
Osteomyelitis interventions
Non-surgical
- IV antibiotics (Vancomycin)
- PICC line
- Wound care
- Hyperbaric Oxygen therapy
surgical:
sequestrectomy (may be performed to deride the necrotic bone)
amputation